[Effect of scrotal reconstruction with free skin graft on spermatogenesis].

OBJECTIVE

To summarize the effect of free skin graft for repairing scrotal avulsion injury, and to investigate the repair impact of the method on spermatogenesis.

METHODS

Between June 2001 and June 2010, 8 cases of complete avulsion injury of the scrotal skin were treated with the free skin graft, aged 22 to 64 years (mean, 29 years). The causes of injury included machine twisting in 4 cases, animal attack in 3 cases, and traffic accident in 1 case. The time between injury and hospitalization was 1-7 hours (mean, 3.5 hours). Five cases complicated by avulsion of penile skin, 3 by perineal laceration with exposure of testes and spermatic cord, and 1 by avulsion of leg skin.

RESULTS

After 10 days, 80% to 95% grafted skin survived. The reconstructed scrotum had shrinks and the wound healed by first intention after dressing change. Eight patients were followed up 12 to 24 months (mean, 16 months). At last follow-up, the patients had relaxed and droop scrotum, and penile erection was normal. Semen quality analysis showed: semen volume of 2-6 mL (mean, 4.2 mL); complete liquefaction with liquefaction time of 15-30 minutes (mean, 23 minutes); sperm density of (12-27) x 10(6)/mL (mean, 16 x 10(6)/mL); sperm motility of 45%-65% (mean, 56%); and sperm motility (grade A) of 25%-42% (mean, 32%).

CONCLUSION

Complete avulsion of the scrotal skin can be repaired by free skin graft, which has no significant effect on spermatogenesis.